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Dr-A-Greene, Psychologist
Category: Mental Health
Satisfied Customers: 309
Experience:  Clinical and Forensic Psychologist
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My son is 8 years old. We adopted him at 11 months of age

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my son is 8 years old. We adopted him at 11 months of age from Russia. He is generally a good boy and very smart. He skipped 1st grade and is now in 3rd grade. He was diagnosed with ADHD and is on Concerta. He has been making threats to other kids at school. Today he used the bathroom unsupervised and threatened 2 jr high boys that he could stab them with a knife. He did not have a knife but these are threats he is making. The other boys did nothing to provoke this from him. Another threat he made was he told another boy in his class that he would take the mouse cord and strangle him. We have tried every punishment and do not know who to turn to for help! Any suggestions? We have tried counseling but all they do is talk to him and it seems to make matters worse.
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr-A-Greene replied 5 years ago.

First off, I have several questions for you to help me clarify the situation in my head.

1) When you say that you took him to counseling and it made matters worse, how long was he in counseling and was he prescribed anything (other than the Concerta)?

2) When he was in counseling, was he with a Child Psychologist who uses Play Therapy or with a counselor that literally just talked to him like one would talk to an adult?

3) Do you know much about his life in Russia before his adoption (i.e. for example, was he with his mother or with an agency the whole time)?

Customer: replied 5 years ago.
Nothing other than concerta has been prescribed for him at this point, First councilor was new at therapy and tried play therapy with him but he would walk away from her and go play with the toys he wanted to. She would perswaid him to return and talk while playing. This went on for about 9 months and we did not see improvement. The next one we tried just talked to him as an adult but in a mild manner and got him to think about his actions. We terminated visits after 6 months because they were not billing my insurance and told us they dealt with our insurance but turns out they were not listed with the insurance.

His biological (russian) mother turned 16 the day after my son was born. She and her mother tried to raise him but could not afford to so at 5 months of age he was taken to the orphanage and at 6 months they (his mother and grandmother) signed over all the rights to him to the courts. We accepted him at 8 months and met him when he was 10 months then returned to bring him home at 11 months.
He is very kind at one moment and cares about your feelings! He angers easily but usually does not act out at home. He does hit, kick, and hurt his sister who is also adopted from Russia at the same time. She is 2 years older than him but no biological relation. He ususally just says things to other kids at school and does not act on them. Most of what he says is not something he can do but threatens it. As of today he is on in school suspension and in solitare room for 2 days.
Expert:  Dr-A-Greene replied 5 years ago.

Thank you for answering my questions. That helps a lot & backs up what I was originally thinking. So, I wanted to give you this website to look at (you may have to copy and paste into your browser) if you haven't been directed to take a look at the symptoms of Conduct Disorder already.

I strongly suspect that this is what is happening with your child and that it may have been misdiagnosed due to his age. 8 years-old is young for conduct disordered behaviors to begin and a lot of clinicians won't recognize it or will "softball" it with a lighter (easier to hear) diagnosis. Additionally, he isn't exhibiting many of the symptoms yet, but it sounds like he is beginning to. Threatening, theft, and school suspension are hallmarks of this disorder. My guess is that, if not treated, the more serious violations of the rules will come later.

Conduct Disorder has a mixture of causes including genetics (which we don't know much about). Also, your child probably had Reactive Attachment Disorder beginning in his earliest months (the most critical time for attachment) due to his precarious home situation. Finally, he has ADHD, which is another risk factor for Conduct Disorder. Add the emotional stress of adoption to that and there is pretty strong evidence that this is what is happening.

Conduct Disorder is something that can be hard to treat, but its not impossible. First off, I would say that you need to find a psychologist (who works in conjunction with a psychiatrist, if possible) who specializes in treatment with children. Given his young age, the correct mode of therapy for him (regardless of his intellectual or verbal skills) is play therapy (by someone who knows what they're doing). It is extremely effective when done right. There will be family components that you can address and he may also need medication prescribed by a psychiatrist.

Anyhow, I will wait for your thoughts on this. There may be some components or information that I'm missing, so I don't want to go on and on. Please let me know.

Customer: replied 5 years ago.
OK we live in a small town and I will have to go to the bigger city to find a psychologist/psychiatrist to help with this. I will take him to our MD and have him reccomend someone to help with this. Your help has been wonderful and I will show this to my husband. I will also bring this up with the Dr.! Thank you so much for your time!
Expert:  Dr-A-Greene replied 5 years ago.

You're welcome Maureen. I'm so glad to hear that you're so involved already with the little guy's care. I think that with the right treatment he has a great chance of returning to all the loving behaviors that you know he can display. He just had some risk factors for this that were outside of his control.

I wish you all the luck in the world -

Take care,

Dr. G.

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